Results From The Singapore Mental Health Study: Retrospective Observation Of Mental Disorders During Postpartum Period – Similarly Chong Et Al

Prevalence of mental disorders throughout the ‘two year’ period following pregnancy was found to be low in the current sample.

Being married, employed, and the absence of chronic physical conditions were found to be protective factors for the mental health of women who have children.

So a peak in estimated hazard rate for anxiety disorders was noted at the time of giving birth. With that said, this finding should however be interpreted with caution, as marital status was obtained at the time when the respondent was being surveyed and as such may not accurately reflect the marital status of respondents at the time of pregnancy and throughout the postpartum period. Previous studies have found the role of social support, particularly support provided by spouses to be a protective factor against mental disorders during this critical period. Only marital status and employment stood out as significant factors in influencing women’s mental health in the current study, with regards to sociodemographic variables. These findings paralleled those of Subramaniam et al, who found single mothers to have significantly higher odds of having mood disorders as compared to those who were married.

Divorced and separated women were more going to have an onset of mental disorder after pregnancy, or within the 2year period following pregnancy, compared to married women.

Among individuals with mood disorders, 5, 1percentage, and 5.

Among female respondents with children, 5. Especially, obsessional thoughts pertaining to fear and concern of causing harm to the infant are common. Anxiety disorders/symptoms are commonly reported in the course of the ‘prenatal’ period during which the mother might be concerned about the impending delivery of the child and the associated changes in social roles and responsibilities that this brings forth. Antenatal anxiety actually, had been linked to physical defects in the infant, low birth weight, and poor cognitive and neurodevelopment. Nonetheless, singapore is a multi ethnic country in Southeast Asia with a population of 5 million.

Chinese ethnicity, 13 dot 3percent are Malay, 1percent are Indian, and 3 belong to other ethnic groups. Singapore ranks relatively high in regards to Human Development Index per capita) and ranks low in regards to ‘Genderrelated’ Development Index, an index designed to measure gender inequality across the aforementioned three dimensions. Despite the low prevalence of mental disorders during pregnancy and the ‘post partum’ period, the current findings were in line with past literature which has shown the prevalence of mood and anxiety disorders to be relatively higher in the course of the postpartum period. Given the limited research with regards to pre and post natal psychiatric disorders particularly within the local context, the current paper aims to further build on the understanding of the epidemiology of women’s reproductive mental health by utilizing data from the Singapore Mental Health Study to explore the temporal relationship of pregnancy and child birth on mental disorders. Therefore this included age of woman at the time of interview, ethnicity, income level, marital status, educational level and employment status.

Sociodemographic information was collected using a structured questionnaire. CIDI checklist of chronic medical conditions was used to assess the presence of the following conditions. With that said, this finding was replicated by Leung et al. In a multicenter prospective study among Japanese women for example, Kitamura et al. Hong Kong whereby antenatal depression significantly predicted an approximate 28percentage of the variance in postpartum depression. That said, antenatal depression or anxiety had been consistently implicated as a significant risk factor, with regards to postpartum depression. Anxiety and depressive disorders actually, have received extensive attention in this place of preand ‘post natal’ research given their high comorbidity and the adverse effects that these disorders have on both the mother and the infant. It is all participants and parents of participants aged ’18 20years’ provided written informed consent prior to study participation. Respondents were randomly selected from a national registry, and were approached at their households for facetoface interviews. Divorced or separated, and widowed women, and widowed women. I know that the study was approved by the relevant institutional ethics committee. Marital status stood out as a risk factor for the occurrence of a mental disorder at any time point after a woman’s first pregnancy.

In contrast to past local studies, ethnicity was not found to be significantly associated with the onset of mental disorders.

Similarly, Chong et al.

Chinese as opposed to other ethnic groups. Chong et al. Consequently, singapore, found Indian ethnicity to be significantly associated with a high risk of depression. Therefore, absence of chronic physical conditions and being employed also served as protective factors for women in the current sample. It is women who were married, employed and physically healthy were less gonna have developed any mental disorder than those who were not. Past literature for example, has suggested a link between gender based violence during pregnancy and the incidence of psychiatric disorders. Additionally, we were not able to differentiate the effect of ageing and child birth on respondents’ mental health status, all of which are important factors that can impact women’s mental health. That said, given that not all pregnancies last 9months, now this may have resulted in an over estimation of the prevalence of mental disorders throughout the postnatal period. With that said, estimation of age at first pregnancy was an approximate created out of subtracting the age of the first biological child from the respondent’s age and further deducting 1year.

We were also unable to detect the cases of subclinical levels of depression, and panic disorder as the study did not establish these diagnoses.

We were unable to examine the effect of miscarriage, abortion, child death, and genderbased violence on females’ mental health in the current study.

The low prevalence in the current sample warrants careful interpretation of results given the insufficient statistical power. Retrospective design of the current study also limits inference of causality. As the CIDI does not contain a specific question targeted at female respondents with regards to reproductive events, we were not able to gauge a more precise pregnancy age. However, look, there’re limitations in our study. For example, in addition to ‘multigenerational’ households in which the ‘daughterinlaw’ has little autonomy was identified as possible risk factors for ‘genderbased’ violence, these factors however were not explored in this study. Factors similar to bias against female babies, role restrictions. Life table estimation method was used to derive the estimated hazard rate for any mood or anxiety disorders following pregnancy. Among women with children, 5percent were found to have an onset was suggested for psychiatric conditions during pregnancy and the postpartum period. Generally, Chee et al, while our study utilized the CIDI to establish diagnoses of mental disorders including depression.

In contrast to our study, Chee et al.

For instance, particular symptoms like changes in appetite or weight, fatigue, sleep disruptions in the CIDI are reported to be poor regarding the discriminating between clinical depression and ‘normative experience of pregnancy’ given the overlap of symptoms between these two.

Though well validated, the CIDI isn’t specifically developed to assess psychiatric symptoms associated with disorders during pregnancy and postpartum. Of course thus, while severe cases of postnatal depressions could’ve been detected, less severe presentations could’ve been overlooked as natural consequences of childbirth. Let me tell you something. Singapore to have either major or minor depression and 12 dot 5percent to have anxiety disorders, that were relatively higher than our finding of 9 for mood disorders and 7 for anxiety disorders. One possible reason for this discrepant finding between Chee et al.

Edinburgh Postnatal Depression Scale designed specifically to measure postpartum depressive symptoms.

This is in contrast to lowincome and ‘lowmiddle’ income countries whereby poverty not only limits access to proper and timely health care but also restricts their ability to afford these services.

One reason for the low prevalence of postpartum depression among Singaporean women as compared to other Asian countries going to be due to Singapore ranking relatively higher looking at the HDI compared to other countries. Besides, the high amount of development not only allows individuals to have access to good quality healthcare services but also allows them to seek proper treatment for these psychiatric conditions. MDD symptoms to be lowest among noninstitutionalized Taiwanese adults followed by Koreans and Americans. Conversely, past studies have suggested some difference in symptom expression between the Western and Asian populations. Asians to have a higher tendency to somatize their symptoms compared to the Western population whereas Hwu et al. Oates et al. Asian cultures to have a ‘relatively high tolerance for or denial of emotional sufferings’. In line with this, Liao et al. Of the 3317 female respondents in the SMHS, 2278 reported having biological children. Furthermore, the age at first pregnancy was deduced by first subtracting the age of the first biological child from the woman’s age and further deducting 1year from this to account for the duration of pregnancy.

With OCD being the most prevalent mental disorder within 2years after a woman’s pregnancy, the onset of anxiety disorders in the current study was found to be associated with the time of pregnancy and particularly in the postpartum.

OCD in the adult Singapore resident population to be considerably lower than those in western countries.

Evolutionary theories for example, posit that intrusive thoughts and obsessional thoughts may to some extent represent adaptive behaviors meant to protect their infants from possible harm. Similarly, Subramaniam et al. That said, this finding corroborated with past research which have shown anxiety disorders to be common in the course of the postpartum period. Now regarding the aforementioned fact… Singapore adult population compared to the US. Basically the current finding of high prevalence of OCD was also partially supportive of an earlier study conducted by Chong et al. Although, with increased vulnerability following delivery, the prevalence of mental disorders during pregnancy and postpartum was found to be low among women with children in our community sample.

It’s a well-known fact that the perinatal period is identified as a period of vulnerability for various disorders, that have been associated with negative outcomes for both mother and infant.